University of Texas Health Science Center at Houston, USA.
University of South Carolina, USA.
J Telemed Telecare. 2023 Jul;29(6):426-434. doi: 10.1177/1357633X20987704. Epub 2021 Jan 26.
Telehealth is an increasingly popular treatment delivery modality for mental healthcare, including evidence-based treatment for complex and intense psychopathologies such as post-traumatic stress disorder (PTSD). Despite the growing telehealth literature, there is a need for more confirmatory research on satisfaction with PTSD telehealth treatment, particularly among veterans, for whom the most rapid and permanent expansion of telehealth services has been implemented through the Department of Veterans Affairs.
The current paper integrates data from two concurrent PTSD treatment outcome studies that compared prolonged exposure therapy delivered both in person and via telehealth for veterans ( = 140). Using two different measures of satisfaction (the Charleston Psychiatric Outpatient Satisfaction Scale-Veteran Affairs Version (CPOSS) and the Service Delivery Perception Questionnaire (SDPQ)), we hypothesized that PTSD improvement would predict satisfaction, but that delivery modality (in person vs telehealth) would not.
Results only partially supported the hypotheses, in that PTSD symptom improvement was associated with greater satisfaction, and in-person treatment modality was associated with satisfaction as measured by the CPOSS (but not the SDPQ). Subgroup differences by sex were found, such that male veterans, typically with combat-related trauma, were more satisfied with their PTSD treatment compared to female veterans, who were most frequently seen in this study for military sexual trauma.
Altogether, results illustrate a need for additional satisfaction studies with diverse samples and large sample sizes. Future research may benefit from examining satisfaction throughout treatment, identifying predictors of greater PTSD improvement, and further examining demographic subgroups.
远程医疗是一种越来越受欢迎的精神保健治疗方式,包括针对创伤后应激障碍(PTSD)等复杂和强烈精神病理学的循证治疗。尽管远程医疗文献不断增加,但仍需要更多关于 PTSD 远程治疗满意度的确认性研究,特别是在退伍军人中,退伍军人是通过美国退伍军人事务部最快和永久性扩展远程医疗服务的人群。
本论文整合了两项同时进行的 PTSD 治疗结果研究的数据,这些研究比较了针对退伍军人的面对面和远程进行的延长暴露疗法( = 140)。使用两种不同的满意度衡量标准(Charleston 精神科门诊患者满意度量表-退伍军人版(CPOSS)和服务交付感知问卷(SDPQ)),我们假设 PTSD 改善会预测满意度,但治疗方式(面对面与远程)不会。
结果仅部分支持假设,因为 PTSD 症状改善与更高的满意度相关,而面对面治疗方式与 CPOSS(但不是 SDPQ)衡量的满意度相关。还发现了性别亚组差异,即患有与战斗相关创伤的男性退伍军人与女性退伍军人相比,对 PTSD 治疗的满意度更高,而在本研究中,女性退伍军人最常因军事性创伤就诊。
总的来说,结果表明需要对不同样本和大样本量进行更多的满意度研究。未来的研究可能受益于在治疗过程中检查满意度,确定 PTSD 改善的预测因素,并进一步检查人口统计学亚组。